Remote Prior Authorization Pharmacist - Flexible, Impactful

Pharmacy Careers; Warwick (RI); Remote; USD 90,000 - 130,000; Full time

Benefits offered by this job

Remote work

Flexible schedule

Career growth

Benefits

Job summary

Pharmacy Careers is seeking a Remote Prior Authorization Pharmacist to review requests from home, applying evidence-based criteria to determine medical necessity and plan coverage. You will collaborate with medical directors, document decisions clearly, and support process improvements for faster turnaround and better member access, with a 100% remote, flexible schedule and no weekend requirements.

Requires active U.S.

Qualifications

• PharmD or Bachelor of Pharmacy degree required.
• Active, unrestricted U.S. pharmacist license required.
• Hospital, ambulatory, community, or clinical pharmacy background valued; new grads welcome.

Responsibilities

• Review prior authorization requests for clinical appropriateness and medical necessity.
• Apply guidelines, formulary rules, and regulatory standards to approve/deny requests.
• Communicate determinations to providers and members with clear documentation.
• Collaborate with medical directors and clinical teams on complex/high-cost cases.
• Document decisions in CMS/state/health-plan compliant manner.
• Support process improvements to reduce turnaround times and improve member experience.

Skills

Clinical judgement

Written communication

Criteria-based review

Attention to detail

Education

PharmD or Bachelor of Pharmacy

Job description

Pharmacy Careers is seeking a Remote Prior Authorization Pharmacist to review requests from home, applying evidence-based criteria to determine medical necessity and plan coverage. You will collaborate with medical directors, document decisions clearly, and support process improvements for faster turnaround and better member access, with a 100% remote, flexible schedule and no weekend requirements.

Requires active U.S.